Did you ever wake up in the middle of a dream and wonder, for just a minute, if what you were dreaming about was real? It can feel so disorienting until you open your eyes and take in your familiar surroundings. An experience like this can give you just a short peek into the ongoing disorientation for a person with dementia. When confusion about place, time, and even identity settle in for a person you love, you have two options for responding: either reorient someone with dementia to reality, or step into theirs.
Which Reality Is Best?
In a nutshell, each approach has a role in dementia care. However, there are specific cautions to be familiar with in using reality orientation. It is important to first understand what is involved in both options and when they may be most beneficial.
Accepting Their Reality
Living in an alternative reality is quite typical for a person in the mid to later stages of dementia. The person may believe they are a young adult engaged in their previous career (or a different one altogether), with a spouse and young children to care for. Going along with their perception of reality helps them maintain a sense of self-worth and purpose. It instills peace and comfort, and is oftentimes the recommended approach.
Reality orientation, on the other hand, involves providing cues and prompts about the current date, time, and location. Research indicates that using this approach to reorient someone with dementia to reality can improve cognitive functioning, particularly when paired with donepezil, and help with some of the more challenging facets of dementia.
Reality orientation, however, must be handled gently and with skill, compassion, and awareness of the individual’s emotional state. For instance, if the person asks where their mother is, it could be incredibly harmful to respond, “Why, she died 40 years ago! You’re 95 years old, so there is no way your mother could still be alive.” In contrast, it could be helpful in ordinary conversations. For example, if the individual wakes up and asks what day it is, you may say, “Today is Thursday, the day you have your doctor’s appointment and then dinner with Sally.”
If the person seems to become agitated or anxious with reality, it is always advisable to join them in the perceived reality that feels comfortable to them.
Our specially trained caregivers are pros at knowing how to effectively engage someone with dementia and make each day the very best it can be. We use creative, customized approaches that help with communication, memory, comfort, and safety, while promoting independence and a feeling of purpose and self-worth.